Vaginal Progesterone Gel Extends Pregnancy, Lowers Preemie Rates

Progesterone, a naturally occurring hormone, which can also be applied as a vaginal gel, reduces the rate of preterm birth in women that have a short cervix, which is a risk factor in these types of incidences. Progesterone, in essence, can prolong pregnancy.

The study found that infants born to women who had received progesterone were less likely to develop respiratory distress syndrome, a breathing complication occurring in preterm infants.

Roberto Romero, M.D., program head for Perinatology Research and Obstetrics and chief of the Perinatology Research Branch explains:


“Our study demonstrates that progesterone gel reduces the rate of early preterm delivery, less than 33 weeks, in women with a short cervix. Women with a short cervix can be identified through routine ultrasound screening. Once identified, they could be offered treatment with progesterone.”

Progesterone is naturally secreted by the ovary in the second two weeks of the menstrual cycle. Progesterone has been used also as therapy for PMS syndrome and for women with infertility or frequent pregnancy loss. Progesterone is made in the ovaries of menstruating women and by the placenta during pregnancy. About 20-25 mg of progesterone is produced per day during a woman’s monthly cycle and up to 300-400 mg is produced daily during pregnancy. Progesterone is a precursor to most steroid hormones and performs a myriad of different functions.

Infants born preterm are at high risk of early death and long term health and developmental problems. In 2005, there were 12.9 million preterm births worldwide. In the United States, 12.8% of infants were born preterm in 2008. Preterm infants are at increased risk for death in the first year of life, and breathing difficulties, cerebral palsy, learning disabilities, blindness and deafness.

Dr. Romero explained that progesterone is a naturally occurring hormone which is essential to maintain pregnancy and that a short cervix is thought to be a sign of a possible shortage of progesterone.

Progesterone acts to stabilize the tissue lining of the uterus (endometrium). If it is absent or low, irregular and heavy menstrual bleeding often occurs after a period without any menstrual bleeding. Thus progesterone is used to prevent this irregularity of bleeding when it is given continuously. If, on the other hand, a onetime bolus of progesterone is given such as with a shot or with only 5 days of oral pills, then the falling progesterone levels will actually cause an estrogen-primed endometrium to slow and therefore start a menses.

Too much progesterone often causes tiredness and even sedation. This side effect can be beneficial in a woman who has epilepsy or even uterine irritability causing preterm labor because progesterone in high doses can decrease seizure activity and uterine contractions.

Progesterone tends to promote vaginal dryness by counteracting the effect on lubrication of estrogens. It can also decrease the amount of menstruation or block it entirely by reversing estrogen effect on the growth of the uterine lining. If a woman has stopped having menses on a birth control pill, the progestogen component needs to be decreased if menstrual bleeding is desirable.

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Source: Wiley Online Library

Written by Sy Kraft, B.A.

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